Welcome

Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and
others concerned about HIV/AIDS. Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the
conversation yourself by registering on the left side of this page.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive
and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a
username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own
physician.

All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators
of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please
provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are
true and correct to their knowledge.

Author
Topic: need expertise (Read 2572 times)

I know a few of you understand these lab results with as much clarity as some doctors. I've been rooting through my 1,000's of papers all dealing with medical issues. I've mentioned before that I was dianosed with Hep B in the early 90's and have found some documents pertaining to it. I'm thinking now that they just used these results to arrive at a diagnosis.

AST/SGPT was 879ALT/SGPT was 1735; there was a comment indexed to them that reads; Rechecked and STAT broadcasted; Patient results continue to be in panic range. Previous results were reviewed and called; results printed to floor.

T Bili was 13.83D Bili was 8.65GGTP was 147

Since I now know that I didn't have Hep B, can anyone who understands these number hazzard a guess to what was going on? My doctor won't do so. I'll eventually let this go, but I lived with this disease for 15 years and didn't even have it.

It has always bugged me, that's all. I knew in my heart that I didn't have Hep B, as I was quite aware of how it is contracted and I hadn't been involved in any of those activities. But I also can't seem to let it go wondering what else was going on and if there's an underlying issue.

Yeah, I was horribly sick Matt. I went beyond yellow and was a bright shade of orange. Dropped down under a 100 pounds and couldn't even ingest water. That was the days before privacy was a concern, some of my family found out about my AIDS diagnosis that day before I had a chance to inform them. They didn't expect I was leaving through the front door so I guess they thought it didn't matter.

One would never make a definitive diagnosis off those numbers -- without doing a Hep panel (at least one would hope not). Clearly something was going on with your liver at that time. Your results are amazingly close to mine when I had Hep A (confirmed with a Positive Hep A Surface Antigen, IgM test).Back in my lab days, we rarely saw numbers like that except in Hepatitis or Cirrohsis. It's impossible to tell at this point. Can you tell me again -- how do you know that you didn't have Hep back then (A, B or C)?

I'd put money on hepA. It's dead easy to catch. There was an outbreak in London 10 years or so ago traced to salads in a posh restaurant. But there you go, you are well now, yes? Did they not do relevant antibody panels etc? My liver panel was similar, if not quite so sky-high, when I had hepA but not when I had hepB. With hepA I too was, like, guest star in the Simpsons.

But then again, the liver is a mysterious organ, and many things can affect it for a short and extreme while, including some opportunistic infections connected with low CD4 count, some of which have difficult presentations and may not have been on the physicians' radar liver-wise. << dumb but common a while back and even now

Since we're OT about the various Heps and how to test for and interpret results, how does one know for sure that they have / don't have Hep (A,B,C, etc.)? Is it like HIV in terms of having a window period, antibody tests, RNA tests? Seems like a muddy picture in terms of diagnosis, please fill me in if you can.

I'm convinced HIV itself can cause liver probles (although I'm not sure to that extent). Prior to me being diagnosed positive, my liver enzymes were elevated. They tested me for Hep A/B/C and all were negative (plus I was previously vaccinated for hep a and b. I had an ultra sound and it was discovered my liver was enlarged. I was referred to a specialist and after a bunch of tests it was discovered I had HIV.

I have since read that liver disease is major cause of death for HIV positive people (even those who are negative for hepatitis). So I am convinced of a relationship.

Those numbers you showed are right around where mine were when I had Hep A in 2001 and was hospitalized for 8 days.... I was extremely sick --- and actually caught it from a salad I ate at a restaurant (I know because two hospitals in the area confirmed that there had been other cases around the same time as mine and a common denominator was salad eaten at this particular restaurant) [oh, and no jokes about it coming from "tossed salad" or tossing salad --- ]

It came on pretty suddenly - high fever, extreme fatigue, pain in abdomen, sore all over, nausea --- it completely had me messed up --- I wouldn't wish it on my worst enemy (alright, maybe I would - but only a mild case ----- I'm trying to be more honest this year)

My bet is it was Hep A --- a test should show if you have antibodies to Hep A which if you haven't been vaccinated would be attributed to having had it before.Same with the Hep B.

My bet is it was Hep A --- a test should show if you have antibodies to Hep A which if you haven't been vaccinated would be attributed to having had it before.Same with the Hep B.

However -- an absence of said antibodies does not mean that you did not have Hep A or B. Some people have a drop off in antibody titer -- most don't, but some do -- some quickly, some over a longer period. That is the bitch with this -- it is easy to rule in, if tested -- but not altogether easy to rule out, after the fact. I would simply let this go -- your liver seems to have recovered, no? The likelihood that you will find your answer is slim -- unless you've never had an antibody test -- you could try that and then drop it.

However -- an absence of said antibodies does not mean that you did not have Hep A or B. Some people have a drop off in antibody titer -- most don't, but some do -- some quickly, some over a longer period. That is the bitch with this -- it is easy to rule in, if tested -- but not altogether easy to rule out, after the fact. I would simply let this go -- your liver seems to have recovered, no? The likelihood that you will find your answer is slim -- unless you've never had an antibody test -- you could try that and then drop it.

Hugs,M

Is it possible to entirely rid yourself of the virus, leaving no antibody to show a previous infection? When I switched to my current ID doctor, he ran all the antibody tests and indicated I never had any infection. I went through the 3 shot procedure to inocculate myself. I'll eventually drop it, but it has always gnawed at me. I'm not sure how I've made it this long with the less than stellar medical attention I rec'd.

Your body deals with viruses by producing various antibodies. How long these remain depends on you and the virus in question. Sometimes it's a lifetime (effectively) and sometimes less. It really does depend on the individual and the virus in question. Since vaccinations tend to produce weaker antibody responses than the real deal this is why you are advised to top up eg every 5 years, 10 years on many vaccinations.

I had hepA and hepB about 15 years ago. I still have detectable hepB antibodies but not hepA antibodies. << this is the first year they were too low to equate to "immune" The "fade" is variable then....

Hep A and B tend to be acute diseases and the body rids itself of the virus. Hep C can go either way. Given your lab results from back then, I would think the best a doctor could say is that you don't have any antibodies to Hepatitis A,B,C. To state that you never had Hepatitis is not something that could said with any surety. Your labs certainly suggest that something was up with the liver -- something that you recovered from. This certainly puts hepatitis into the realm of possibilities. Not sure why you would have results like that and NOT had a Hepatitis work up done, but that is water under the bridge now. Let it go -- you're healthy now!

Because I had recently started a thread about my own "Hep B Chronic - to have or not have that is the question" (or something like that) thread - and this thread deals with some concerns Wolf has.... I thought it appropriate to post the response that I received via email today from my ID doc in regards to my questions about my insurance showing that I had recently been reported via a claim as having Hep B Chronic (see thread for additional background):

From phild's ID doc:

"....We can revisit this with the new set of serologies, but most likely they will just show past infection. In any case, the backbone of Atripla contains 2 drugs that are active against Hep B, so even if you had it, it would be extremely unlikely to be active at this point.

I'm pretty sure my issue has to deal with a coding error tied to the labs which were ordered that day for my next round of labs (to occur in March) - which include Hep A, B, C testing. At any rate, we shall see....

And Wolf - I can understand why it would bother you - but as long as your current labs are clear and your liver functions are intact, then I agree that I would let it go - and just continue to be proactive on your current and future medical care - as I am sure you are and appear to be.

I guess I was fortunate that I showed up early for my doctor's appointment because he had a no-show and I got to spend almost an hour with him. I brought him all the paperwork from that hospital admission. He agreed to review them if I'd finally let it go. He is still pretty certain that it wasn't Hep B. His best guess is that it was an active CMV infection, possibly soon after acquiring it. It could also have been a gallstone that blocked a bile duct while trying to pass. And there are numerous other things, although less likely, that could have presented with the same numbers.

He also indicates that there's no record of virology tests to indicate the presence of a virus. He also brought up a good point; this diagnosis occurred in the ER of a rural hospital 20 years ago. It was most likely assumed it was Hep B since I was a gay man with AIDS and presented myself with jaundice and elevated numbers.

Other than that, everything looked great; labs wise. The we moved on to fun shit, like scheduling my next scope. I'm not returning to the same surgeon who performed my ass surgery this Spring. We still have not rec'd a detailed report from him after numerous requests. So I'm getting a new referral. Then I had him look at the splinter that has been impaled in the bottom of my foot for a few months now. Now I have another referral to have a damn plantar wart removed.